Back to Search
Start Over
Modified frailty index as an indicator for outcomes, discharge status, and readmission after lower extremity bypass surgery for critical limb ischemia.
- Source :
-
Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing [J Vasc Nurs] 2020 Dec; Vol. 38 (4), pp. 171-175. Date of Electronic Publication: 2020 Sep 12. - Publication Year :
- 2020
-
Abstract
- Frailty has been associated with poor postoperative outcomes. This study evaluated the 5-factor modified frailty index (mFI-5) to assess complications, mortality, discharge disposition, and readmission in patients undergoing lower extremity (LE) bypass for critical limb ischemia (CLI).The National Surgical Quality Improvement Program vascular module (2011-2017) was utilized to identify patients undergoing LE bypass for CLI. Adverse events included infectious complications, bleeding complications, prolonged ventilation, amputation, readmission, and death. Patients were divided into groups based on mFI-5 scores: mFI1 (0), mFI2 (0.2), mFI3 (0.4), and mFI4 (0.6-1). Data were analyzed using the Cochran-Mantel-Haenszel statistic for general association and multivariable logistic regression. About 11,530 patients undergoing bypass for CLI were identified (42% rest pain and 58% tissue loss; 23% mFI1, 31% mFI2, 27% mFI3, and 19% mFI4; 64% men and 36% women). An increase in mFI-5 was associated with higher 30-day mortality (mFI1 = 0.62%; mFI12 = 1.45%; mFI13 = 1.35%; and mFI14 = 3.09%; P < .0001). After adjustment for age, mFI4 was associated with increased mortality compared with mFI1 (odds ratio, 3.80; 95% confidence interval, 1.69-8.54). Increased mFI-5 was associated with bleeding complications, wound infections, urinary tract infections, prolonged ventilation, sepsis, unplanned reoperations, and discharge to nonhome destination (all P < .01). Compared with mFI1 (13.5%), mFI4 was associated with increased 30-day readmission (24.8%, P < .0001). In patients undergoing LE bypass for CLI, higher mFI-5 was associated with increased postoperative complications, in-hospital and 30-day mortality, nonhome discharge, and 30-day readmission. The mFI-5 as an easily calculated tool can identify patients at high risk for inferior outcomes. It should be incorporated into discharge planning after LE bypass for CLI.<br /> (Copyright © 2020 Society for Vascular Nursing. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Female
Humans
Intermittent Claudication mortality
Intermittent Claudication surgery
Male
Middle Aged
Postoperative Complications mortality
Postoperative Complications therapy
Frailty
Ischemia mortality
Ischemia surgery
Lower Extremity blood supply
Lower Extremity surgery
Outcome Assessment, Health Care statistics & numerical data
Patient Discharge statistics & numerical data
Patient Readmission statistics & numerical data
Peripheral Arterial Disease complications
Subjects
Details
- Language :
- English
- ISSN :
- 1532-6578
- Volume :
- 38
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of vascular nursing : official publication of the Society for Peripheral Vascular Nursing
- Publication Type :
- Academic Journal
- Accession number :
- 33279105
- Full Text :
- https://doi.org/10.1016/j.jvn.2020.08.002